Thursday, September 26, 2013

Changes in Pregnancy

 Pregnancy is a natural process.  But it is a special condition which needs due care to have best outcome.  Various changes occur in the body during the course of pregnancy, delivery and lactational period.  All these changes in the woman help growth of the fetus and newborn. 
Some changes are obvious and external and some may present as symptoms in pregnancy.  As the fetus grows, the abdominal girth increases, becomes maximum by ninth month.
Enlargement of the abdomen is more obvious after 5th month.  In the initial phase there is increase or fullness noted in the lower abdomen as the uterus grows and starts entering abdomen from below (pelvis).  Increasing size of the abdomen after 7th month may result in stretch marks and their pigmentation.  The stretch marks are due to stretching of the abdominal skin beyond its elasticity.  Stretch marks may not appear in all women.  The protuberant abdomen may result in change postural change to maintain balance.  Also the changes in the pelvic joints preparatory to delivery may result backache.   
As the urinary bladder is close to the uterus, along with uterus the urinary bladder gets upward displacement.  In the last few weeks of pregnancy, in thin woman, urinary bladder when filled can be seen as a bulge in the lower part of abdomen.
The size of the breasts also increases, areola darkens, and small tubercles are seen on the areola.  Veins may become prominent and stretch of breast skin may result in stretch marks and they may be pigmented.  Sometimes there can be thin, watery secretion from the nipples after 5th month. 
Apart from these external changes there are internal changes in the body.  The apparent increase in salivation is due to nausea resulting in failure to swallow it.  Sometimes gums may be swollen and bleeding from them can occur at the time of brushing.  The hormonal changes in pregnancy results changes in the stomach.  After a meal stomach takes more time to get emptied.  Some woman may experience acidity problem.  Slow movement of food in the stomach and intestines will cause more absorption of water and constipation is a common problem in pregnancy. 
The most important changes that occur are in the heart and blood circulation.  Heart has to supply blood to uterus to sustain the growing fetus.  It has to pump more blood per beat and number of beats increases as the pregnancy advances.  The increase in heart rate will be 15/min than non-pregnant state. The blood volume also increases and by term, it could be almost 50%.  The coagulability of the blood also increases.  These changes help in tolerating and limiting blood loss at the time of delivery.  
The changes in kidneys will help in clearing the waste products of increased metabolism in the body.  The efficiency of kidney increases. 
There are also changes in the lungs.  The increase in the size of uterus and becoming abdominal organ pushes the diaphragm upwards.  The respiratory rate increases per minute.  Woman may sometimes feel breathing laborious. 
To sustain growth of fetus and increasing metabolic process of the pregnancy there are insidious changes in the metabolism of carbohydrates, proteins and fats. 
All pregnant women gain weight.  The increase in weight is not just because of the fetus and placenta or increased size of the uterus but also increased maternal weight.
A healthy woman tolerates all these changes and will have successful outcome.

All the changes that occur in pregnancy will revert to normal by the end of three months after delivery.  

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